Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review
Abstract
:1. Introduction
2. Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Society/Institute/Group | Year | Country | Target Population | Recommendation | Management after Cytology | Age | Grade | HPV Testing |
---|---|---|---|---|---|---|---|---|
New York State Department of Health AIDS Institute [17] | 2007 | USA | HIV-positive patients | Anal cytology at baseline in HIV-infected populations: - MSM - History of anogenital condylomas - Women with abnormal cervical and/or vulvar histology | - Normal cytology to be repeated annually. - Refer patients with abnormal results ≥ ASC-US for HRA. | Any age. | ND | ND |
Northwest Pennsylvania Rural AIDS Alliance [18] | 2011 | USA | HIV-positive patients | Anal cytology at baseline in all HIV-positive. | - Normal cytology to be repeated annually, especially for HIV-positive MSM. - Patients with a low CD4+ T-cell count (<500 cells/mm3) should be monitored 6–9 months (author suggestion). - Refer patients with abnormal results ≥ ASC-US for HRA. | ND | ND | High and low-risk HPV. Not included in the algorithm management. |
HIV Medicine Association of the Infectious Diseases Society of America [19] | 2014 | USA | HIV-positive patients | Anal cytology in HIV-positive patients: - MSM - Women with receptive anal sex - Women with abnormal cervical cytology - History of genital warts | ND | ND | Weak. Moderate quality evidence. | ND |
The American Society of Colon and Rectal Surgeons [20] | 2018 | USA | High-risk populations: - HIV-positive - MSM - History of cervical dysplasia | Anal cytology may be considered in high-risk populations. Not for universal screening. | ND | ND | Weak. Moderate quality evidence, 2B. | HPV testing may be used as an adjunct to screening. |
American Society of Transplantation Infectious Diseases Community of Practice [21] | 2019 | USA | Solid-organ transplanted patients | Anal cytology for solid-organ transplant patients: - History of receptive anal intercourse - History of cervical dysplasia | - Normal cytology to be repeated every 1–3 years. - Refer patients with abnormal results ≥ ASC-US for HRA. | ND | Weak. Low quality evidence. | ND |
European AIDS Clinical Society [22] | 2018 | - | HIV-positive patients | Digital rectal exam ± anal cytology in HIV-positive patients: - MSM - Persons with anogenital HPV-associated dysplasia | - Normal cytology to be repeated in 1–3 years. - Patients with abnormal results should be referred for anoscopy. | ND | ND | ND |
Spanish AIDS Study Group/Grupo de Estudio de SIDA (GeSIDA) [23] | 2014 | Spain | HIV-positive patients | Anal cytology in HIV-positive patients: - MSM - Women with cervical cancer or HSIL - History of anogenital condylomas | - Normal cytology to be repeated annually. - Refer patients with abnormal results ≥ ASC-US for HRA. | ND | ND | HPV PCR increases sensitivity. Not included in the algorithm management. |
Several German Societies. Lead Management: Deutsche AIDS-Gesellschaft (DAIG)/German AIDS Society [24] | 2015 | Germany Austria | HIV-positive patients | Anal cytology in all HIV-positive patients | - Normal cytology to be repeated annually. -Refer patients with cytology HSIL for anoscopy (within 3 months). - Other cytology results to repeat cytology in 3–6 months. If the second is abnormal, to refer for anoscopy. | ND | ND | If necessary HPV typing. In case of high-risk HPV > 1 year, these are high-risk patients and should be submitted to anoscopy. |
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Albuquerque, A.; Rios, E.; Schmitt, F. Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review. Cancers 2019, 11, 1942. https://doi.org/10.3390/cancers11121942
Albuquerque A, Rios E, Schmitt F. Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review. Cancers. 2019; 11(12):1942. https://doi.org/10.3390/cancers11121942
Chicago/Turabian StyleAlbuquerque, Andreia, Elisabete Rios, and Fernando Schmitt. 2019. "Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review" Cancers 11, no. 12: 1942. https://doi.org/10.3390/cancers11121942
APA StyleAlbuquerque, A., Rios, E., & Schmitt, F. (2019). Recommendations Favoring Anal Cytology as a Method for Anal Cancer Screening: A Systematic Review. Cancers, 11(12), 1942. https://doi.org/10.3390/cancers11121942